This 23 year old patient has lived full time as a male for 3 years, has been on testosterone therapy for 9 months, and came to Minneapolis Plastic Surgery for transgender total mastectomies, nipple/areola reduction, and reconstruction in a masculine pattern. Incisions are chosen to avoid female breast reduction scar patterns, and proper nipple/areola graft position is necessary to give a normal male chest appearance. Outpatient surgery was performed in our AAAASF-accredited office surgical facility. Drains and skin graft dressings were removed in one week; protective vest and all bandages finished at 3-4 weeks from surgery. Scars will fade over 6-12 months.